Diabetic retinopathy is responsible for approximately 15% of blindness in the United States. Among Blacks, the prevalence of diabetes is high and the incidence increasing; thus, diabetic retinopathy and associated visual impairment represents a major public health problem for the U.S. Black population. The overall goal of this study is to ascertain factors for developing severe diabetic retinopathy (in order ultimately to identify patients who are likely to develop the condition), in Blacks with type I (insulin dependent) diabetes mellitus. In order to achieve this goal, we will investigate the frequency of diabetic retinopathy using a graded classification scheme, and relate retinopathy severity levels to several specific risk factors. We hypothesize that presence and severity levels of diabetic retinopathy in diabetic Blacks are significantly associated with five putative risk factors: longer duration of disease, female gender, poor glycemic control, high blood pressure, and low socioeconomic status. The patient population for our study will be comprised of type I diabetic Black patients, as identified from the New Jersey Hospital Discharge Data. Clinical evaluation of patients will include ocular examination, fundus photography, a structured clinical interview, and a dietary questionnaire. Laboratory evaluation will include measurement of blood and urine samples to assess glycemic control, insulin insufficiency, diabetic renal disease, and blood antioxidant levels. Presence and severity levels of diabetic retinopathy will be related to the risk factors identified above. Diabetic retinopathy among Black diabetics is a condition in dire need of investigation. Our proposed studies will yield the first comprehensive data on severity levels of diabetic retinopathy and contributive risk factors in type I Black diabetic patients. Furthermore, it is expected that these data will provide a basis for public health education strategies and treatment modalities to prevent or reduce severity of diabetic retinopathy in all diabetic patients.